Form Fh Reg 190-5 - Affidavit In Support Of Claim For Exemption Of Arizona Licese Tax (In Lieu Tax) By Nonresident Service Personnel

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STATE OF ARIZONA-COUNTY OF COCHISE
AFFIDAVIT IN SUPPORT OF CLAIM FOR EXEMPTION OF ARIZONA LICESE TAX (IN LIEU TAX)
BY NONRESIDENT SERVICE PERSONNEL
(FH REG 190-5)
________________________________________, being first duly sworn oath deposes and says: That he
(she) is not an Arizona resident but is a legal resident of the State/Country of
____
_________________________ and is presently stationed at Fort Huachuca in compliance with
,
military orders.
That he (she) is not a registered voter in the State of Arizona for non-presidential elections.
That he (she) is _____ sole _____ joint owner of the vehicle described below, for which tax exemption is
being claimed, and that said vehicle IS NOT USED IN OR ARISES FROM A TRADE OR BUSINESS IN THE
STATE OF ARIZONA:
YEAR_____ MAKE______________ BODY STYLE __________ I.D. NO. ____________________________
AFFIANT_________________________________
X
STATE OF
)
RANK
_____________________________________
) SS
COCHISE COUNTY
)
15
29TH
June
Subscribed and sworn before me this _______ day of ____________________________ 20__________.
________________________________________
COMMANDING OFFICER OR PROVOST MARSHAL
FH FORM 190-1-R-E
REPLACES FH FORM 1319-R-E, 1 OCT 94, WHICH IS OBSOLETE
15 MAY 97
FH PE v1.00
PRIVACY ACT STATEMENT
AUTHORITY: Title 10, USC, Sec 3012(g).
PRINCIPAL PURPOSE: The Social Security Number is used for Law Enforcement purposes as an additional means of
identification of subjects, suspects, witnesses or complainants.
ROUTINE USES: Your Social Security Number is a major item used in processing machine record
and output sequence for Military Police Management Information Systems.
DISCLOSURE: OF YOUR SOCIAL SECURITY NUMBER IS VOLUNTARY. However, failure to provide your SSN may delay
or preclude registration of a privately owned motor vehicle on the military installation.

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